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Delay in diagnosis and treatment of acute myocardial infarction is directly related to increased morbidity and mortality, and missed MI accounts for more money paid in malpractice suits than any other condition. These authors assessed whether the rate of missed MI is related to the annual number of MI patients treated in an emergency department.
They conducted a retrospective chart review of 19,663 patients with a diagnosis of acute MI who were admitted through an ED to 171 acute care hospitals (17 teaching hospitals and 154 community hospitals) in Ontario during 1 year. Annual ED MI volume was categorized as very low (0–49 cases), low (50–99), medium (100–199), high (200–299), and very high (≥300).
Overall, MI was missed in 2.1% of patients …